Infosys Helix-Empowering Better Care
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Empowering Better Care
<small><small><p style="color:#00000"></small></small></p>Sam Has the Power To Change Healthcare
Platform Powered | AI-First |
Sam has been part of the payer ecosystem for over 20 years.
He has witnessed the transformation of care from the brick-and-mortar model to the hybrid one it is today.
As someone who’s always ahead of the game, Sam’s always looking for new possibilities.
Is the Future of Healthcare Rooted in AI?
In an increasingly digitized world, what can the healthcare industry do to keep up? The pandemic was a wake-up call for most industries. But, it particularly put a strain on our healthcare industry.
Hospitals find themselves being pulled apart by the demands of different healthcare stakeholders. And harnessing the power of data and AI-driven technology will allow personalization and provide the right foundation for value-based care.
Sam needs an ecosystem that lets him connect and engage with stakeholders.
He wants to deliver a seamless experience for providers, businesses and members alike. And while he has experimented with several platforms and technologies, he hasn’t been able to achieve the desired outcomes.
What outcomes do you hope to achieve through transformation?
- Lower cost & higher profits
- Better experiences
- Evolution of the care ecosystem
- All of the above
While attending a conference, he learns about Infosys Helix.
A suite of independent, interoperable, intelligent platforms that can be plugged into existing infrastructure without disruptions. It’s a solution that’s Platform-Powered, AI-First, People-Centric and above all else, Empowering.
Each platform includes several modules that solve specific problems.
From orchestrating a care marketplace to democratizing access, Sam can now use these building blocks to do it all and more. And as the needs and challenges of the industry evolves, so will Infosys Helix.
With limitless possibility at his fingertips, Sam can now solve some of the oldest healthcare challenges in a brand new way. And without a moment's hesitation, he begins the execution.
Payers will evolve to become aggregator of health data and facilitator of clinical care pathways for their members.
Sam uses Helix to shift from a traditional to a digital operating model.
But that’s not all… He leverages the Payer B2B platform to hyper-personalize employer-sponsored plans, accelerates the growth of his provider network with Provider Lifecycle Management, and uses Payer on Cloud to transform his business with intelligence as the cornerstone.
How much has your digital transformation progressed?
- 25% - 50%
- 50% - 75%
Sam now has the power to change healthcare
Sam quickly realizes that Infosys Helix is more than just a software-as-a-service or process-as-a-service; it’s empowerment-as-a-service for a wide range of needs.
Using the suite, he can now take the experience he delivers from fragmented to integrated. He is thrilled with the value he has been able to add for his provider, employer and member counterparts.
Do you have an Amazon-like care ecosystem?
<small><small><p style="color:#00000"></small></small></p>Dave Can Deliver an Amazon-Like Experience for His Employer Groups
As an account manager, Dave deals with employer-sponsored plans.
The different employer groups he serves have distinct employee demographics with unique requirements. Employer groups contribute 40%-45% of the firm’s total revenue. And Dave needs to be able to deliver the flexibility and customizability they demand.
What proportion of your revenue comes from employee-sponsored insurance?
- 25% - 50%
- 50% - 75%
Limited plan options are one of the many challenges Dave faces.
As healthcare costs rise, so do employer spends and out of pocket expenses for their employees. Tracking utilization of plans is another challenge for him.
He needs a solution that can help mitigate costs for employers, enhance the experience for employees and ease his burden.
His organization onboards Infosys Helix Payer B2B.
A disruptive B2B health plan platform that can help him engage employers and providers in a collaborative marketplace to enhance trust and employee satisfaction.
Dave solves challenges with modularity and simplicity.
It offers several modules including broker engagement, benefits planner, health concierge, and more. Dave can now provide employer groups the flexibility to create customized benefit plans and provider networks.
Dave gives his employer groups more control.
The self-service capabilities offered by the Payer B2B platform lets employers buy, manage and service the healthcare needs of their employees.
The platform helps create a personalized experience for employees and tightens control over the cost of care.
As a payer, can you offer the flexibility employers need to deliver the care their employees deserve?
Healthy employees mean happy employers.
Employees now have access to an adequate provider network and relevant benefits. From ailment to appointment, and treatment to payment, the platform delivers a rich personalized experience that’s current, reliable and comprehensive.
Dave’s clients lauded the fact that they saw a steep drop in attrition since the new plan was introduced.
Are you losing employer group business due to limited flexibility in plans offered?
Dave adds real value for his employer groups.
The Infosys Helix Payer B2B platform lets Dave tailor, track and transform employer-sponsored plans. Today, Dave delivers actionable insight that drives down costs and provides an elevated experience for his plan sponsors.
What’s more? He can do this for every business he serves.
Are you able to provide your employer groups the capability to create custom plans?
<small><small><p style="color:#00000"></small></small></p>Jennifer Can Deliver Uber-ized Possibilities for Providers
Provider Lifecycle Management
Jennifer manages the provider network at her firm.
From recruiting to onboarding, and contracting to credentialing, she manages all kinds of provider engagements. Over the years, she has built a relationship with her provider partners.
Today, she hopes to deliver a new experience that can help her gain their trust.
80% of the contracts that exist today between payers and providers are standard contracts
She wants to find a better way to engage providers.
As someone that works closely with physicians and doctors, Jennifer understand the challenges they face. In addition to holding lives in their hands, providers have to deal with a significant amount of documentation and administrative bureaucracy.
She wants to find a way to ease their burden and help deliver better care for members.
Administrative work consumes one-sixth of U.S. physicians' working hours and lowers their career satisfaction.
Legacy systems limit the experience she can deliver.
After much deliberation, Jennifer’s organization onboards the Infosys Helix – Provider Lifecycle Management platform. A comprehensive solution that delivers provider recruitment, online application, credentialing, contracting, provider data management, provider finder services and provider network management.
Digital contracting and automated credentialing accelerates onboarding.
From initiating conversations to signing the contract, she is now able complete the entire process in 2 short weeks. But the value added by the Provider Lifecycle Management platform doesn’t end here…
How much time does it take you to onboard providers?
- >1 month
- 1-2 months
- 2-4 months
- >4 months
Jennifer grants her provider network access to rich insights.
The platform helps her automate and optimize provider data management and and provider network management. It also enhances the provider experience by augmenting their decisions with AI-based insights and recommendations.
The benefits delivered also trickle down to her members.
What’s more? Members have access to a wide range of specialists at their fingertips. Jennifer can now deliver the care they need and the experience they deserve.
Jennifer is now able to manage her provider network efficiently.
With the Provider Lifecycle Management Platform, Jennifer can connect with and engage providers with ease. The platform has also helped convert her provider partners into advocates.
And now, you can too!
<small><small><p style="color:#00000"></small></small></p>Sharon Can Take the Lego Approach to Transformation
Payer on Cloud
Sharon was recently appointed the Transformation Lead of a payer firm.
In her new role, she’s tasked with overseeing the adoption and implementation of next-gen technologies. While technology has come a long way in the past decade, her firm hasn’t embraced the digital possibilities.
She wants to make change real.
But the monolithic legacy IT landscape of her firm stands in the way. The failure to sense, adapt and evolve has also led to a rise in administrative costs.
She needs to find a way to achieve operational efficiency without compromising on member effectiveness. And she looks for a way that technology can help her address this challenge.
The US Healthcare industry is making the transition to a digital core operating model. Infosys is enabling a seamless transition with platforms that address specific clinical and administrative inefficiencies in the traditional model.
Sharon learns about the different solutions available.
After a significant amount of research, she decides to onboard Infosys Helix – Payer on Cloud Platform. A core administration platform that powers real-time, cloud-native, workflow-based, AI-embedded, configurable processes.
Sharon decides to put the Payer on Cloud platform to work.
The platform is offered as modular, independent, inter-operable functional blocks that Sharon can assemble like Lego bricks. Now, she can transform one function at a time without disrupting the day-to-day operations of her business.
Sharon uses the platform to explore new digital territories.
Using the different modules offered by the Payer on Cloud platform, Sharon is able to create efficiencies and deliver better outcomes.
With labour-intensive tasks now automated, she can focus on adding value for her stakeholders through enriched experiences.
Which approach would you choose for your transformation?
Quicker resolutions lead to better experiences for and higher retention of members.
Leveraging the different modules of Payer on Cloud, Sharon can now fuel progress at her firm with agility at the core. She is now able to transform the way her business works.
However, this is just one of the many digital possibilities the platform has delivered for her.
Is your operating model:
The Payer on Cloud platform lets her innovate to zero.
Zero fallouts, zero latency, zero wastage, zero tech debt and zero friction. The platform has empowered Sharon shift from a risk-focused model to member-centric one.
And as the industry evolves, so does the platform, making her business future-ready.
<small><small><p style="color:#00000"></small></small></p>Diana Can Offer Hyper-Personalized Employer Plans
Plan Sponsor Engagement Module
Diana deals with employer-sponsored plans on a daily basis.
She initiates conversations with employer groups, discusses the benefits her firm offers and closes deals. But her role doesn’t end here.
She also manages the utilization of these plans and their renewal.
In 2019, around half of the people with health insurance received private insurance
through their employer.
The times are changing, and Diana needs to be able to keep up with change.
Over the years she’s noticed that rising healthcare costs have become a burden for her clients. When employer-sponsored plans are quickly becoming the new normal, she needs to find a way to manage these plans more efficiently.
Different businesses have diverse workforces and distinct needs. And Diana wants to offer customized plans for the businesses she serves.
Have rising healthcare costs impacted your organization’s spends?
She wants to be able to tailor unique plans for each employer group she serves.
Diana wants to move away from the traditional one-size-fits-all approach to employer plans. She needs a flexible solution that gives her clients transparency into core payer processes. A solution that offers customization and real-time recommendations on cutting costs.
And she believes that technology is key to delivering this flexibility.
After evaluating the possibilities, her firm chooses to onboard the Infosys Helix – Payer B2B – Plan Sponsor Engagement Module. A single solution that offers limitless possibilities for the customization of employer-sponsored plans.
Employer groups can now customize the benefits and providers of the plan.
Diana leverages the Plan Sponsor Engagement Module to connect with employers, converse with benefits managers and convert them into clients.
How long does it take for you to create a custom report for cost/utilization trends?
- 1-2 weeks
- 2-4 weeks
- >4 weeks
The solution also gives her clients transparency.
Diana’ s clients can now manage enrollment of employees and monitor plan utilization in real-time. The platform also gives employer groups access to recommendations on how they can curb costs. Businesses can now give their employees the care they deserve.
The enriched experience helps Diana retain her clients, while they retain their employees.
The self-service feature lets the employers mix and match the benefits to fit their employee demographic.
Diana can now take the one-size-fits-one approach for all her business clients. What’s more? She can manage multiple plans with a single dashboard.
<small><small><p style="color:#00000"></small></small></p>Zack Can Accelerate Provider Credentialing From Months to Days
Provider Lifecycle Management
Zack leads the provider credentialing process at his firm.
His role encompasses obtaining, verifying, assessing and validating the credentials of physicians that are being added to his firm’s provider network. As his organization grows, more providers need to be onboarded, faster.
And it’s his responsibility to ensure that the providers joining the network are adequately qualified.
After collecting the required information, the credentialing process can take anywhere between 120 – 150 days.
When provider data is manually verified, it is often inaccurate and rarely up to date.
Fragmented provider data makes credentialing a drawn out process. It’s not just time consuming but effort intensive and expensive. Additionally, provider data needs to be updated regularly.
How long does the provider credentialing process take for your organization?
- < 1 month
- 1 – 2 months
- 2 – 3 months
- > 3 months
He thinks of technology as an enabler and seeks a solution that can address his challenges.
Zack needs to be able to expand his network at a rapid pace while ensuring that his members get the quality of care they deserve. He needs a comprehensive solution that can help him achieve better results, faster.
Around 85 percent of all medical credentialing applications contain missing, inaccurate, or out-of-date information.
At a quarterly meeting, he highlights the potential value of digitizing the process.
The board of directors at his firm assess the different solutions in the market and select the Infosys Helix - Provider Lifecycle Management - Credentialing Module. An independent solution built to automate the credentialing process from end to end.
Zack can now transform provider credentialing at his firm.
From documentation to verification, he leverages the Credentialing module to automate the process. The solution also carries out quality checks on a continuous basis and auto-corrects the provider data. Zack can now complete provider credentialing in real-time.
Zack can now communicate with providers and get documents attested, digitally.
The solution also collects and connects self-reported professional data from more than 1.4 million healthcare providers. It also gives Zack the flexibility to configure workflows that let him manage credentialing, re-credentialing, committee reviews and approvals with ease.
Have you ever used a provider credentialing automation software?
Zack can now shape a verified provider network with ease.
With the Infosys Helix Credentialing Module, Zack can now deliver a seamless credentialing process. He leverages the platform to accelerate and simplify credentialing. What’s more? He can grant physicians visibility into the entire process.
And now, so can you!
<small><small><p style="color:#00000"></small></small></p>Jessica Can Finally Digitize Her Provider Contracts
Provider Lifecycle Management
Jessica is in charge of provider contracting at her firm.
The years of experience she has gives her a deep understanding of the the ins and outs of the process. Her firm wants to rapidly grow their provider network in the coming years but Jessica doesn’t think that this is possible with the existing system.
Standardization is not always synonymous with simplification.
While 80% of Jessica’s provider contracts are standardized, iterations complicate the process. Her firm currently uses physical documentation for contracts which slows down the process even more.
Typically, it takes her 2 – 4 months to close a single contract.
How long does your provider contracting process take?
- < 1 month
- 1 – 3 months
- > 3 months
Provider contracting is a complex process and doesn’t end at sign-off.
In addition to creating new contracts, she also tracks utilization of existing contracts and initiates renewals when required. With multiple provider contracts in different stages, Jessica feels like she can no longer manage them effectively.
She needs a solution that can help simplify and optimize the process.
Have you considered leveraging technology to accelerate the process?
She does her research and shares a proposal with her firm’s board of directors.
After reviewing the proposal thoroughly, her board selects the Infosys Helix – Provider Lifecycle Management – Contracting Module. A human-centric, experience-based, AI-Augmented solution that digitizes contracting and negotiations.
In virtually no time, the Contracting Module is integrated into the infrastructure and Jessica gets straight to work.
She logs onto the platform and triggers the creation of a new contract.
The Contracting module reads and extracts the information, classifies provisions and reimbursement details and generates a contract. And it does it all autonomously.
Jessica peruses the details of the new contract and makes the necessary edits before sharing the draft with the provider.
The provider receives the first draft instantly.
Along with a legal team, the provider reviews the contract and suggests amendments as they see fit. The AI algorithm then accepts, rejects, or routes these changes for further review. The terms and conditions of the contract are negotiated digitally.
Once Jessica and the provider reach an agreement, the contract is finalized and signed by both parties.
How many new contract templates do you create every year?
She now has more control over every aspect of provider contracting.
What’s more? Jessica has visibility of real-time utilization data and can initiate the renewal process in a timely manner. She can also configure the workflows as per her requirements and manage templates, reviews and approvals, digitally.
Simpler processes result in better experiences.
From intent to authoring, review to refining and approval to signing. Jessica is able to accelerate the entire contracting process. The solution also lets her track the utilization of multiple contracts through a single dashboard.
Today, Jessica offers providers a seamless contracting process. And so can you!
<small><small><p style="color:#00000"></small></small></p>Steve Can Onboard Providers in a Matter of Weeks
Provider Lifecycle Management
A provider can be onboarded after credentialing and contracting.
As the provider networks manager, Steve’s role includes the recruitment and onboarding of new providers. He wants to grow his network and make care more accessible for his members.
The number of payers a provider is registered with is limited. And the onboarding experience delivered can make a real difference.
More than 40 percent of providers
are enrolled in 10 - 19 commercial health insurance networks or plans
Cost and process inefficiencies are becoming a challenge for him.
Legacy and point solutions along with manual documentation makes onboarding a lengthy, time-consuming and complex process. Adding a single provider to his network takes Steve almost 3 months. The drawn out process also impacts administrative costs.
How much time does your organization take to onboard providers?
- < 2 week
- 2 – 4 weeks
- 4 – 6 weeks
- > 6 weeks
Steve believes that it’s time for change.
He wants to leverage technology to drive change and deliver a superior experience for his providers. He needs a solution that can simplify and speed up the onboarding process. One that can be easily integrated with the firm's existing infrastructure.
Do physical documentation and legacy systems restrict the experience you deliver?
He explore different digital possibilities in the marketplace.
After weighing the pros and costs of solutions Steve shortlisted, his firm chooses the Infosys Helix – Provider Lifecycle Management – Onboarding Module. An independent, intelligent solution that digitizes the provider onboarding process.
Steve couldn’t wait to see how the solution worked and what it could do.
Steve can now overcome the limitations of legacy systems.
Steve leverages the Onboarding Module to digitize the application process. With intuitive onboarding, he is able to recruit providers that are not just qualified but verified. The platform also cross-checks the provider data against the primary source in real-time.
Now, he can rapidly and simultaneously recruit multiple providers.
Has your organization digitized the provider onboarding process?
Maintaining network Adequacy is no longer a challenge for him.
The Onboarding module also monitors network adequacy and alerts Steve as and when new providers need to be recruited. It gives him access to insights and recommendations throughout the onboarding process and augments better decision making.
He can now review, edit and approve contracts online.
Steve can also deliver transparency and visibility of the onboarding process and expected timelines. The solution sends alerts and notifications on the progress of the application to the providers.
From document submission to network admission, and every phase in between, the provider can track the progress of the application.
Steve now has the power to transform his provider onboarding process.
He leverages smart recruitment to onboard several highly quality providers and grow his firm’s network.
He is able to ease the administrative burden of his provider network, deliver a seamless experience for them and grant his member access to the care they deserve.
And now, so can you.
<small><small><p style="color:#00000"></small></small></p>Jane Can Create Customized Care Pathways for Everyone
Payer on Cloud
As a care administrator, Jane needs to be data-oriented.
Throughout her professional career, Jane has worked with data. From collection to analysis and interpretation to decision making. Her role encompasses every phase of the data management process.
She is also responsible for data exchanges between providers, vendors and other stakeholders.
An International Data Corporation (IDC) found that big data is projected to grow faster in healthcare than in sectors like manufacturing, financial services or media. It is estimated that the healthcare data will experience a compound annual growth rate (CAGR) of 36 percent through 2025.
Jane doesn’t have a data repository for her member health information.
While healthcare data is growing at 36% annually, most of the data is siloed and unstructured. Jane knows that data is everywhere. However, it resides at different sources and in different formats. And as the number of members she serves rises, so does the complexity of her role.
Today, managing this disparate data for every members has become a real challenge for Jane.
Globally, the big data analytics segment is expected to exceed $68.03 billion by 2024, driven largely by continued North American investments in electronic health records, practice management tools, and workforce management solutions.
Jane wants to address her challenges and drive change.
Lately, she has noticed that gaps in information and inaccuracies are impacting the experience she delivers and the care her members receive. While there’s no dearth in the volume of data, it rarely adds real value.
Jane needs a solution that can help her convert volume to value. Not just for her but across her value chain.
Do you have a unified view of your member data?
Jane explores the possibilities that technology can deliver.
After doing the groundwork, Jane discusses the potential value that data can deliver with her board. And following a vote, they decide to onboard the Infosys Helix – Payer on Cloud – Health Module. A solution that creates a single repository that’s accessible by multiple stakeholders.
Jane has a complete view of member health data at her fingertips.
The solution combines the historical information from medical records and real-time data from wearable devices with genomic data to give Jane a comprehensive view of the member’s health.
This dashboard can also be shared with vendors, providers, pharmacies, state governments, and more.
Jane can also help her provider network create customized care pathways.
As part of the Health Module, the Digital Twin creates a digital replica of the member to help providers diagnose the underlying problem, evaluate the potential effects of a specific medicine, and prescribe the best course of treatment. To do so, it consolidates the member information, correlates the data and delivers actionable insights and recommendations.
The Health Module helps Jane enrich every experience that she delivers.
From enrollment to claims management and everything in between, Jane now has the insight she needs to make better decisions across every function. The solution also accelerates the resolution of member issues, delivering a seamless experience.
The Infosys Helix Health Module gives Jane the tools she needs to make data do more.
Can you leverage data to enrich experiences?
<small><small><p style="color:#00000"></small></small></p>Andre Can Transform the Enrollment Experience for His Members
Payer on Cloud
Enrollment is typically the first interaction a member has with a payer.
As the enrollment manager at his firm, Andre understands the value of making a good first impression. He wants to shape an unforgettable enrollment experience for his members.
But legacy systems and outdated processes stand in his way.
You never get a second chance to make a first impression.
As the scale of enrollment increases, so do the complexities of the process.
Paper-based documentation, labor-intensive processes, scalability and control are among the significant challenges he faces on a day-to-day basis. Andre thinks that next-gen technology can help him lower administrative costs and improve access to care for members.
He needs a solution that can help him digitize and simplify the process from end-to-end.
Andre learns about the Infosys Helix Coverage module at a roundtable conference.
When he gets back to the office, he discusses his challenges with and vision for enrollment with the board of directors. He also highlights the potential outcomes the Coverage module could drive.
After further consideration, Andre’s firm onboards the Infosys Helix - Payer on Cloud - Coverage Module. A product capable of transforming the enrollment process.
Without delay, he initiates the transformation.
From documentation to verification, configuration to reconciliation, and communication to satisfaction, Andre can now automate the enrollment process with the Coverage module.
But that’s just one of the many layers of value the platform delivers.
Have you automated enrollment at your firm?
Andre can now leverage Artificial Intelligence to make a real difference.
The module grants Andre access to current insights on trends and patterns in enrollment. It also empowers him with predictive, actionable recommendations in real time and helps him make better decisions, faster.
Data security is another long-standing concern that the module has resolved for him.
The Infosys Helix Coverage module is secure-by-design and HIPAA compliant. It also facilitates digital authorization, accelerating the consent process. Andre no longer has to worry about sensitive health data being leaked without the member’s knowledge and consent.
Andre can now enroll members with ease.
The solution collects the data, verifies eligibility, enrolls the member and offers 360-degree visibility into the process. All that’s left for Andre to do is approve the application.
He can now deliver a timely and seamless enrollment process. Can you?
How long does the enrollment process take for your firm?
- <24 hrs
- 24-72 hrs
- >72 hrs